Lies About Women's Health

For the past 15 years, Ruth Shaber, M.D., has been an ob-gyn in San Francisco for Kaiser Permanente, one of the nation's largest health maintenance organizations. She sees all types of women—union members, executives, waitresses. Most of them, Dr. Shaber says, have questions for her, including how to protect themselves from sexually transmitted diseases, how to preserve their fertility, how to prevent breast and cervical cancer and whether the latest Internet health scare they've heard is really true.

Dr. Shaber tries hard to separate fact from fiction because, she says, "rumor and hearsay can start to seem real." In the past, she'd sometimes refer patients to government websites and printed fact sheets, or rely on those outlets to help create her own materials. Not anymore. "As a physician, I can no longer trust government sources," says Dr. Shaber. She is not a political activist or a conspiracy theorist; in addition to her own practice, she's Kaiser Permanente's director of women's health services for northern California and head of the HMO's Women's Health Research Institute. Yet this decidedly mainstream doctor and administrator says, "I no longer trust FDA decisions or materials generated [by the government]. Ten years ago, I would not have had to scrutinize government information. Now I don't feel comfortable giving it to my patients."

Such doctor mistrust represents a major change. For the past 100 years, the Food and Drug Administration (FDA) has been the world's premier government agency ensuring drug safety. The National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) have similarly stellar track records. But recently, Dr. Shaber charges, the government has lost its most precious asset: credibility.

How did it happen? Many prominent figures in science and public health think they know the answer. "People believe that religiously based social conservatives have direct lines to the powers that be within the U.S. government, the administration, Congress, and are influencing public-health policy, practice and research in ways that are unprecedented and very dangerous," says Judith Auerbach, Ph.D., a former NIH official who is now a vice president at the nonprofit American Foundation for AIDS Research. In fact, Glamour, has found that on issues ranging from STDs to birth control, some radical conservative activists have used fudged and sometimes flatly false data to persuade the government to promote their agenda of abstinence until marriage. The fallout: Young women now read false data on government websites, learn bogus information in federally funded sex-education programs and struggle to get safe, legal contraceptives—all of which, critics argue, may put them at greater risk for unplanned pregnancies and STDs.

"Abstinence is a laudable goal," says Deborah Arrindell, vice president of health policy for the nonpartisan American Social Health Association, an STD-awareness group. "But it is not how young women live their lives—the reality is that most women have premarital sex. Our government is focusing not on women's health but on a moral agenda." Consider this a wake-up call.

YOU MAY NOT HAVE ACCESS TO EMERGENCY CONTRACEPTION

If it had been left up to the FDA's Reproductive Health Drugs Advisory Committee, American women would be able to walk into any drugstore and buy the emergency contraceptive Plan B over the counter (OTC). When the committee was convened in 2003 to review Plan B, a "morning-after" method of birth control that can reduce the odds of pregnancy by 95 percent if taken within 24 hours of unprotected sex, all 28 members agreed that the drug was safe and effective. The vast majority of them also voted to make it available OTC at any pharmacy. Susan F. Wood, Ph.D., then the head of the FDA's Office of Women's Health, heartily supported that decision.

Because of her focus on women's health, Wood examined the research and closely watched the review process for Plan B, a drug that has been available by prescription since 1999. Among the facts: Several studies showed that it works with few side effects and that making it more accessible does not lead to an increase in unsafe sex or promiscuity. In 2000 alone, the drug prevented approximately 51,000 abortions, according to a Guttmacher Institute estimate. But women who need Plan B often have difficulty obtaining a prescription and getting it filled—hence the need to approve it for sale OTC.

"One member of the panel told me, 'I wish we had data this good on everything that comes before this committee,'" Wood recalls. Fast approval should have been a mere formality.

But Christian fundamentalist groups like the Southern Baptist Convention and powerful religious conservative organizations like the Family Research Council and Concerned Women for America campaigned hard against OTC status by lobbying members of Congress, testifying before the FDA panels and bombarding the agency with letters. They argued that the drug was dangerous, would lead to unsafe sex and would corrupt children. Pia de Solenni, director of Life and Women's Issues at the Family Research Council (a pro-life group that also believes there are "long-lasting negative consequences of premarital sex," including "emotional problems" and "future marital breakup"), also argued inaccurately in a press release that Plan B "will most certainly make [women] ill from an overdose of hormones and potentially cause further complications."

The campaign worked. Rather than rely on the recommendations of its medical advisory board, the FDA delayed ruling on Plan B for nearly two years. Why? Insiders speculated that the delay was, in part, the handiwork of conservative activist and ob-gyn W. David Hager, M.D., an active member of Christian right political groups and the author of As Jesus Cared for Women: Restoring Women Then and Now. Appointed by the Bush administration to the FDA panel that reviewed Plan B, Dr. Hager first voted with the committee that Plan B is safe and effective, but then went on to write what he termed a "minority opinion," laying out a case against OTC status. Contrary to numerous studies and the review panel's findings, he argued that the drug might not be safe for teens and that they might not understand package instructions. Shortly thereafter, Steven Galson, M.D., a high-ranking FDA official, cited similar concerns in a letter to Plan B's manufacturer—denying the drug approval at that time. Some women's health advocates had hoped that the logjam would break when Lester Crawford, DVM, Ph.D. was confirmed as FDA commissioner in 2005. But last August, Crawford put off a decision indefinitely.

Why did Plan B get deep-sixed? According to FDA officials interviewed by the Government Accountability Office, the decision to deny approval for Plan B had been made by top political appointees at the FDA months before staff even completed reviewing the application; many others suggested that pressure from the religious right played a key role.

FDA spokespeople have denied those accusations, but religious-activist organizations crowed about swaying the FDA, and Dr. Hager claimed the decision was God's work. "I was asked to write a minority opinion that was sent to the commissioner of the FDA," he told an assembly at the Christian Asbury College in Wilmore, Kentucky. "God took that information, and he used it through this minority report to influence the decision."

Crawford's ruling outraged the mainstream medical community. Both Wood and Frank Davidoff, M.D., a consultant to the FDA's Nonprescription Drug Advisory Committee, resigned in protest. Wood, a cautious woman who avoided political issues before this, is still shocked by the decision. "If this drug had nothing to do with sex, this wouldn't have happened," she told Glamour. "This decision was not based on science and clinical evidence. This threatens the FDA's credibility, and it threatens the faith the public has in the FDA for making sure products are safe and effective." The New England Journal of Medicine, the nation's leading medical journal, agreed, running an editorial titled "A Sad Day for Science at the FDA." The decision, it said, "appeared to reflect political meddling in the drug-approval process."

Women's access to emergency contraception (EC) has been mysteriously derailed by political forces in other cases, too. In April 2002, the Department of Defense decided to allow military women the same access to EC that civilian women have, adding Plan B to what's called the Basic Core Formulary, and thus making it available by prescription in all military health facilities. But one month later, Glamour discovered, Defense Department officials, including Assistant Secretary of Defense for Health Affairs William Winkenwerder, M.D., a political appointee, made the extraordinary decision to remove it from the Formulary. Dr. Winkenwerder's office declined to comment to Glamour, but sources familiar with the events say they were stunned by what happened and could not recall any time when a drug was added, then removed a month later. "It was very upsetting," says one, who specifically cites Plan B's "political sensitivity" as the reason for the change. Says another source: "It was like a slap in the face" to be overruled by the civilian leadership.

YOU COULD BE DENIED RAPE TREATMENT

Even the Department of Justice (DOJ) may have been influenced by this political climate. For years, women's advocates have asked the federal government to establish national guidelines for the treatment of rape victims. Hospital protocols, they argued, vary too much from state to state and even county to county, and such guidelines could help a woman traumatized by assault to get good care no matter where she lived.

Mainstream medical organizations, including the American College of Obstetricians and Gynecologists (ACOG), the American College of Emergency Physicians and the American Medical Association, agree that emergency rooms should offer victims EC after a sexual assault. Doing so could prevent the estimated 32,000 pregnancies—and, subsequently, many abortions—that occur as a result of rape. "What person who has been raped would really welcome a pregnancy from that?" says James Trussell, Ph.D., director of the Office of Population Research at Princeton University in New Jersey. "Even if you oppose abortion, what could be better than preventing the pregnancy in the first place?"

So when the DOJ was developing its first-ever guidelines for the treatment of rape victims, an early draft included EC. Yet strangely, in September 2004, when the guidelines were issued, any mention of EC had been deleted.

There was an immediate outcry. A petition signed by hundreds of nongovernment organizations including the American Public Health Association, the Episcopal and Presbyterian churches and the Union of Reform Judaism urged the department "to include the routine offering of emergency contraception to sexual-assault victims." The failure to do so, the petition said, "is a glaring omission."

Congresswoman Carolyn Maloney (D-N.Y.) agreed, and she spearheaded a movement by 97 members of the House of Representatives to demand that the DOJ include the EC information in the guidelines. "I think it is unconscionable to deprive women who have been victimized information about their options for treatment," Rep. Maloney says. "It is unconscionable to deprive them of access to medicine." Her efforts were unsuccessful.

The department has never fully explained why it deleted EC from the guidelines. (A DOJ spokesman told Glamour that EC wasn't mentioned "because it's not up to a bunch of lawyers in the Justice Department to tell doctors what options should be available." But the 130-page document was comprehensive in other ways; it even suggested that examiners avoid wearing jewelry when treating mentally impaired victims.) Rep. Maloney and many others are convinced that they know what drives such decisions. "I'd say it is the fundamentalist right," Rep. Maloney says. At the root of the religious right's objection is the belief that EC constitutes a form of abortion. Most experts agree that EC works by preventing ovulation and therefore fertilization, but scientists cannot rule out the hypothetical possibility that in a tiny number of cases the drug may prevent implantation of a fertilized egg. This loophole has led some pro-life groups to argue that Plan B causes abortions, even though the World Health Organization (WHO), ACOG and the NIH all agree that pregnancy begins at implantation and not before. (The most extreme groups contend that the Pill could work in the same way, and therefore is also a form of abortion. Some pharmacists have even used this reasoning as moral grounds to refuse to fill EC and everyday Pill prescriptions; see "What If You Can't Get EC?" on page 310.) The debate has had real consequences for rape victims: As many as 80 percent of them are kept in the dark about EC or struggle to get it in emergency rooms, according to data from the National Center for Health Statistics.

Maya Jacobsen* was one such victim. In fall 2001, she was raped in her room on campus at the University of Denver. After her attacker escaped through a back door, she sat crying on a couch, frightened and stunned. Like many sexual-assault victims, she was too shaken at first to report the incident and waited until the next morning before she drove to the closest hospital, Porter Adventist. She says she spent hours undergoing a sexual-assault exam, but nobody brought up the issue of how she might prevent pregnancy—until she asked.

"I said, 'What are my options here if I become pregnant?' The nurse said I would have to wait to take a pregnancy test, and if I was pregnant, there was always adoption. I said, 'That's it? What about the morning-after pill?' And she said, 'You would need to do that on your own.'" Fortunately, Jacobsen was able to get the drug from a nearby Planned Parenthood clinic later that day.

Sharon Pappas, chief nursing officer for Porter Adventist, agrees that Jacobsen should have been administered EC if she wanted it. In fact, she says the hospital recently established new procedures reinforcing their policy of offering EC to all rape victims.

But the confusion at Porter Adventist illustrates exactly why uniform federal guidelines for EC are so critical. In the absence of any local laws, it's up to individual hospitals to decide whether a rape victim will be given—or even told about—the drug that could keep her from conceiving her attacker's baby. Many have not developed clear protocols yet, so Jacobsen's experience will be repeated in emergency rooms around the country. Ironically, that could lead to numerous unnecessary abortions. "I would have had an abortion," Jacobsen says. "I had dreams of a career; my whole life was in front of me. Carrying a rapist's child was not my dream."

YOU WON'T GET ACCURATE HEALTH INFORMATION

A few years ago, several conservative congressional legislators asked King K. Holmes, M.D., Ph.D., how well condoms protected against STDs. "They asked whether condoms were effective against everything," says Dr. Holmes, a professor at the University of Washington in Seattle and one of the world's leading experts on STDs. He told them yes, condoms were especially effective against HIV, and worked well against all STDs with one exception: human papillomavirus, or HPV, a few strains of which can cause cervical cancer. At that time, he said, researchers suspected that condoms did offer some HPV protection, but the data were incomplete.

"That is what they wanted to hear," says Dr. Holmes. "It was clear the goal was to discredit condom use, and this was what they were trying to hang their argument on."

It seems that conservative activists saw an opportunity with HPV. Here was a disease connected to cancer against which condoms weren't yet proven effective. The perfect argument against premarital sex, and condoms, was born. "Condoms, whether used correctly and consistently or not, do not prevent the spread of HPV," the Family Research Council warns on its website, going on to note that "HPV has been linked to over 90 percent of all invasive cervical cancers and is the number-two cause of cancer deaths among women." In truth, cervical cancer is only the thirteenth-highest cancer killer of women in the U.S., behind bladder and kidney cancer. In the majority of cases, the immune system fights off HPV before people know they have it. Even when precancerous cells develop, they can be detected early by a Pap smear.

Nevertheless, the HPV fear campaign continued to escalate. Through lobbying and testimony before Congress, the religious right attacked government sex-education programs that included information on condom use. The Family Research Council argued that such programs expose "our youth to incurable disease on a daily basis. Most notable among these diseases is human papilloma virus, HPV." The government appeared to be listening. Until then, the CDC had accurately encouraged condom use as smart safe-sex behavior—but in 2002, around the time of the HPV flap, it backed off. The agency suddenly removed from its website a fact sheet on condoms that stated "laboratory studies show that intact latex condoms are highly effective barriers to…HIV and other STDs" and that told readers how to use them. Later that year, the fact sheet was replaced with one stressing sexual abstinence.

Despite condoms' proven effectiveness against many STDs, especially HIV, conservatives continued to suggest that they were more of a hazard than a help. Just last year, Senator Tom Coburn, M.D., (R-Okla.) went so far as to demand that the FDA place a warning label on every condom package saying condoms don't help protect against HPV. (He was unsuccessful.) The idea, contends Katharine O'Connell, M.D., an ob-gyn and assistant professor at Columbia University in New York City who studies contraception, is to hype the dangers of sex before marriage: Exaggerating condom failure and the risk of HPV "is simplifying the facts for the purposes of manipulating sexual practices," she says. "This is not about condoms. It's all about the sex."

Glamour has also discovered that blatantly false anticondom information has been incorporated into several federal and state health websites. One, an official Department of Health and Human Services (HHS) site designed for families seeking health information for teens, 4parents.gov, suggests that there is no evidence that condom use reduces the risk of HPV infection and downplays its effectiveness against chlamydia, gonorrhea and syphilis. Similarly, several states, including Louisiana, Wisconsin, Virginia and North Carolina, have online abstinence programs that link to a site called abstinencedu.com, which warns that HIV might be able to penetrate a latex condom (patently false), that "condoms offer no protection against HPV infection" (not true) and that "there is no scientific evidence that condoms reduce the risk of becoming infected with the other 23 major STDs" (also false). It even claims that "the Federal Drug Administration [sic] allows up to 4 percent of a batch of condoms to be defective before the batch is rejected!" (Actually, the FDA rejects a batch of condoms if even one-tenth that number are defective.)

How do lies like these become official government health information? Both abstinencedu.com and 4parents.gov get some of their information from yet another outfit, called the Medical Institute for Sexual Health (MISH), which opposes premarital sex and has become a leading provider of the kind of "scientific" data now appearing on government sites.

For more than a decade, public-health doctors and scientists have charged that MISH generates dubious and sometimes outrageously false data. One example: A 1995 letter from David R. Smith, M.D., then the Texas Commissioner of Health, rebuked MISH for a slide presentation given by founder Joe S. McIlhaney, M.D., to a panel of experts about a proposed sex-education program. Dr. Smith called the show "misleading," "false," "inaccurate" and even "ridiculous." Yet MISH continued to present the same data for years, and in the last two years, the federal government gave the group at least $600,000.

Dr. McIlhaney told Glamour that in the early days of MISH, he was still working as a physician, not an academic, and did not have the same access to resources as the now-larger organization does today. Nevertheless, he continues to stress condom ineffectiveness against HPV. "I think our conclusions were right," he says. "I was right on almost all of it, and they were wrong." Yet science does not back him up: Last November the FDA reaffirmed that condoms reduce the risk of every major STD including HPV.

Soon, there will be another weapon even more effective against HPV than condoms. The drug company Merck has found that its new vaccine Gardasil is nearly 100 percent effective against the HPV strains that most often cause cervical cancer. Another vaccine, Cervarix, made by GlaxoSmithKline, appears to be just as effective.

The world's first anticancer vaccine would represent an incredible scientific breakthrough. But conservative groups began voicing objections as soon as the drugs started making headlines. Sen. Coburn, for one, testified before the House of Representatives that "going after one or two types [of HPV] is halfway," a charge health experts find illogical since the HPV strains prevented by the vaccine account for most cases of cervical cancer.

"The public should be outraged at this misrepresentation of facts for political reasons," says Dr. Holmes. "This really reveals the true agenda for those who have argued that the reason for not promoting condoms is to protect girls against HPV." If you truly cared about HPV prevention, his reasoning goes, you'd be thrilled at the advent of a vaccine to save women's lives. "It really illustrates that the opposition to condoms has nothing to do with protecting women and girls," he says, "but everything to do with opposition to discussion of sexual health."

The movement against the vaccine—Merck's version of which could be approved by the end of the year—has left John Santelli, M.D., chairman of Columbia University's Department of Population and Family Health, mystified. "We have a vaccine that could prevent cancer," he says. "People should be lining up and saying this is a great medical achievement, and yet people are actually opposing it. That's nuts."

YOUR TAX DOLLARS FUND MISLEADING SEXUAL-HEALTH PROGRAMS

Teens are perhaps the people most in need of trustworthy sexual-health information. Ironically, they are also the most likely to absorb misinformation from organizations like MISH that provide pseudo-science not just to websites but to abstinence-only sex-ed classes in public schools. One reason why public-health researchers now take a dim view of such programs: They may mislead students. In a meta-analysis of abstinence programs published in the Journal of Adolescent Health, Dr. Santelli found that such curricula "do not seem to be well designed and have incomplete information, misinformation and questionable information." And last year, the office of Congressman Henry Waxman (D-Calif.) examined the most popular federally funded abstinence-only sex-education programs and found that nearly 70 percent of them include "serious medical or scientific errors." Among the wholly inaccurate claims: that up to 10 percent of women become sterile after an abortion and that "premature birth, a major cause of mental retardation, is increased following the abortion of a first pregnancy." Says Princeton's Trussell, "It's an outrage. This is clearly another ideological distortion of what the real evidence shows." Yet such erroneous facts continue to be taught in public school districts in Montana, California, Washington, Pennsylvania and elsewhere.

As a result, many experts believe abstinence-only programs leave teens unprotected against pregnancy and STDs. "These young women and men who are taught that condoms have a high failure rate say, 'Well they do not work anyway, so why bother?'" observes Kellie Flood-Schaffer, M.D., an ob-gyn and associate professor at Texas Tech in Lubbock, where high-schoolers are taught a strict abstinence-only health curriculum. "I'm a Catholic. I believe in abstinence until marriage. But I'm also a realist. And condoms prevent a huge percentage of STDs and are 90 percent effective against pregnancy."

She has data to back up her strong feelings. Along with Samuel Prien, Ph.D., Dr. Flood-Schaffer conducted a lengthy study that found that among girls under 18, the Lubbock area has quadruple the average national rate of chlamydia—an STD that often goes undiagnosed and that can cause infertility. Why are the rates so high? "It's the education they are not getting," says Prien, who considers himself a conservative Christian. "At least in our area, abstinence-only is not working."

YOUR DOCTOR MAY BE FORCED TO LIE TO YOU

In November 2002, the National Cancer Institute (NCI), which is run and funded by the federal government, placed this statement on its website: "Some studies have reported statistically significant evidence of an increased risk of breast cancer in women who have had abortions, while others have merely suggested an increased risk. Other studies have found no increase in risk."

Confusing? Absolutely. But the facts are straightforward: Abortion does not increase a woman's chance of breast cancer, according to numerous independent professional groups like the American Cancer Society, ACOG and the WHO. (Unlike the NCI, these organizations are not part of the federal government.)

Radical pro-life groups partly base their charge of an abortion-cancer link on research by a biochemist named Joel Brind, Ph.D., but his work—subsidized in part by an antiabortion group called Americans United for Life—has been widely discredited. So scientists protested vigorously when the NCI placed the statement on its website, and the NCI convened a special panel to address the issue once and for all.

The group found no increased risk of breast cancer after abortion—and by spring 2003, the NCI had amended its website to reflect that. But serious damage had already been done. The abortion-breast cancer link had gained airtime: Senator Rick Santorum (R-Pa.), speaking on the floor of the U.S. Senate, cited Brind's research to suggest that "abortion increases a woman's risk of breast cancer by 30 percent." And some state governments went further, actually passing laws requiring doctors to tell patients seeking an abortion that the procedure could increase their risk of breast cancer.

"The government allowed people to believe—and encouraged people to believe—that abortions were a risk factor for breast cancer, even when the government knew that this research had been discredited and that better research showed no connection," says Marcia Angell, M.D., a senior lecturer at Harvard Medical School in Boston and former editor-in-chief of The New England Journal of Medicine. She goes so far as to call the pressure from the religious right "a source of corruption."

To date, abortion-breast cancer laws, called "Women's Right to Know," have been passed in Texas, Kansas, Montana and Mississippi. Texas State Representative Dawnna Dukes (D-Austin) vociferously opposed such a law, pointing to the scientific evidence that abortion does not raise the risk of breast cancer. But, she says, legislators who "pushed this law, supported this law, were terrified by right-wing Christian organizations. Some of my colleagues said, in confidence, 'I agree with you, but we are told that if we vote with you on this, we are supporting abortion.' They knew this information was invalid. They were frightened. These folks are afraid of this Christian coalition." Why? She says legislators were worried that the groups would mobilize against them in upcoming primaries. Herb Brown, M.D., an ob-gyn and faculty member at the University of Texas Health Science Center in San Antonio, says these laws "put doctors in a terrible position. You have to show a pamphlet produced by the state to the patient and explain that it is part of the regulation. The conversation I have is that, 'This is what is written in the pamphlet. I disagree with it ethically and scientifically, but this is what the legislation has forced upon me.' That's all I can say… If I want to be consistent with the law, I have to lie."

HEALTH RESEARCH MAY BE STALLED

Before experts can come up with cures or prevention strategies for complex sexual-health problems like STDs, researchers have to discover how diseases are spread, how they change and how they affect people. But in recent years, religiously motivated activists have interfered with that research process, arguing that some studies are immoral.

In 2003, Tooru Nemoto, Ph.D., a public-health expert at the University of California-San Francisco, was conducting a federally funded study of sex workers in massage parlors. He wanted to find out what influenced risky behavior—including why some women chose not to use condoms with customers.

The study had implications far beyond high-risk sex workers. "This is a huge public-health issue," Nemoto says, because massage-parlor workers spread HIV and other STDs to their clients, who then pass on the diseases to their unsuspecting spouses and girlfriends.

But unbeknownst to Nemoto, his study caught the attention of the Traditional Values Coalition, a lobby group that represents more than 43,000 churches. Since the late nineties, the group had been tracking what has been widely reported in mainstream newspapers and scientific journals as a "hit list" of government-funded health projects it found morally objectionable, and, by early 2003, it had given the list to congressional allies. Nemoto's study was on it.

Once again, legislators apparently took the bait. After congressional prodding, HHS began an in-depth audit of Nemoto's project in May 2003 and brought his research to a standstill. After months of scrutiny, the audit uncovered no improprieties, but he narrowly missed losing his funding.

HHS has argued that Nemoto's audit was nothing more than routine. But other groups and researchers say they, too, have been harassed by seemingly punitive reviews. Advocates for Youth, a Washington, D.C.-based research organization that educates teens about topics like drug abuse, sexual violence and birth control, is still feeling the sting. In all, the group underwent three government investigations into how it spent federal money, none of which found any wrongdoing. By the time of the third audit, James Wagoner, the president of Advocates, recalls saying to HHS, "Let's call it what it is. This is the third audit in 11 months. This is starting to feel like more than routine attention." He estimates that the inquiries cost the organization $160,000, money that could have been spent on programs targeting dating violence or preventing teen pregnancy.

Such audits, Rep. Waxman said in a 2003 letter to then-secretary of HHS Tommy Thompson, "are creating at least the perception that [HHS] authority is being abused" for ideological reasons. To support his assertion, he noted that no organizations receiving federal money to promote sexual abstinence had been investigated. (HHS spokespeople never fully responded to Rep. Waxman's queries, and didn't reply to phone calls from Glamour.)

Many scientists believe the audits are part of a larger pattern. In February 2004, 62 leading scientists and educators, including 20 Nobel Prize winners, signed a statement accusing the Bush administration of "misrepresenting and suppressing scientific knowledge for political purposes."

No researcher contacted by Glamour said he or she had been denied funding because of studying sexual issues. But, says Wood, the former FDA official, NIH researchers now practice an "internal self-censorship" because of the way politics have invaded science. The harassment, says Auerbach, the former NIH official, "has put the chill on people. It makes them think twice about their lines of research and their own careers. They do not want to have to spend their lives doing audits. Folks say, 'It is not worth it. I am not going down this line of work.'"

SCIENTISTS FIGHT BACK

It's extremely rare for a scientific conference to turn into something more like a political rally. "Scientists do not normally engage in what is going on in Washington, D.C., or politics," says Wood. But at the annual meeting of the American Association for the Advancement of Science last February, a special conference was added to the agenda to discuss how politics have invaded the realm of science.

It quickly became a standing-room-only event, and scientists applauded as speakers like Wood and Nobel winner David Baltimore, Ph.D., president of the California Institute of Technology in Pasadena, condemned the government's interference in research.

Wood was struck by the overwhelming number of people who attended. "Scientists from across the country, from all kinds of fields, were there," she says, "because they care a great deal about how science is done and how data are analyzed and how the information is used." Why were they finally voicing their fears? "I think as people become more aware [of the interference in science], they are willing to step up and say, 'This is not what we want,'" Wood says.

For a group of researchers, the rhetoric was fiery. Baltimore accused the Bush administration of suppressing science. And when Wood said that morale at the FDA had sunk to a new low because of overwhelming pressure from social conservatives, she got a standing ovation.

Outside of the halls of science, who are the real victims of this political maneuvering? "The American public, particularly American women," says Trussell. "Who's hurt when you can't get EC over the counter? When there is a suggestion that abortion causes breast cancer—something that is entirely made up? When it's suggested that condoms are not effective against STDs, when in reality they are effective against HIV and even HPV? Women."

But many women can't imagine how these lies could possibly have an impact on them, Trussell says. "The first time one of them walks into a pharmacy and can't get her birth control pill prescription filled, that will have a wake-up effect. Most won't feel the effects until these rights are gone—they can't believe there would be a time when these things would be outlawed. I hope their belief is true, but I'm very worried."

Brian Alexander is a contributing editor to Glamour and the author of Rapture: How Biotech Became the New Religion.